Heart failure & cardiomyopathiesCohort study
Shifting From Event Rates to Time at Home After Hospitalization for Heart Failure With Reduced Ejection Fraction: Trends and Equity in Days Alive and Out of Hospital in Singapore
- population-based cohort study
Authors' conclusion
Improvement was seen in 1-year but not 30-day DAOH after first HF with reduced ejection fraction hospitalization, alongside reductions in 1-year HF-specific readmission, all-cause mortality, and cardiovascular mortality. Dissimilar slopes highlight potentially inequitable benefits. DAOH may provide a patient-centered complement to conventional end points for monitoring burden and equity.
Study context
- Population
- Patients discharged alive after first heart failure (HF) with reduced ejection fraction hospitalization during 2011 to 2019, Singapore Cardiovascular Longitudinal Outcomes Databasemedian age, 68.9 years, 31.5% women, 65.4% Chinese, 20.0% Malay
- Participants
- 10,147 patients
- Exposure
- Risk-adjusted annual trends in DAOH, readmission and mortality, 2011 to 2019, with trend heterogeneity by age, sex, and ethnicity
Main finding
As reported in the abstract
annual change
0.01 [95% CI, −0.03 to 0.05] d/y; P -trend=0.554
Observational data: associations, not effects.
Further findings
30-day HF-specific readmission, all-cause readmission, all-cause mortality, cardiovascular mortality
- HF-specific readmission declined
- No change in all-cause readmission, all-cause mortality, or cardiovascular mortality
1-year DAOH
- 1-year DAOH improved from 291.7 to 301.0 days
- 1.16 [95% CI, 0.57-1.75] d/y; P -trend <0.001
1-year HF-specific readmission, all-cause mortality, cardiovascular mortality, all-cause readmission
- HF-specific readmission, all-cause mortality, and cardiovascular mortality declined
- All-cause readmission remained stable
Trend heterogeneity by subgroup
- Declines in HF-specific readmission were steeper in men than women at 30 days and 1 year
- 1-year DAOH gains were greater among Malay than Chinese patients
- after multiplicity adjustment
Original publication
Summarised from the published abstract; every number is checked against it